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Transforming treatment for prostate cancer

Prostate cancer is the most common cancer in men across the UK, with over 46,000 cases being diagnosed each year. This type of cancer usually develops slowly and so men may be unaware that they have it for many years. Symptoms of prostate cancer can include:

Needing to urinate more often than usual

Hesitancy in urinating

Urinary urgency

Weak flow

Straining or taking a long time to finish urinating

A feeling of not emptying the bladder fully

Treatment for prostate cancer depends largely on each patient’s individual circumstances and for many men with low risk prostate cancer, an “active surveillance” approach will be adopted whereby the cancer is carefully monitored and treatment only started if the cancer shows signs of getting worse or causes symptoms. Treatment options for high risk prostate cancer include radical prostatectomy and radiotherapy, however long term side effects of these treatments can include erectile dysfunction and urinary incontinence.

Recent media reports have highlighted a new treatment for prostate cancer in its early stages which has been described as “truly transformative”. The new treatment, called vascular-targeted photodynamic therapy (VTP) involves activating a drug which is injected into the blood stream by using laser light. When the laser is switched on, the drug is activated to kill the cancerous tissue but the healthy tissue remains intact. The Lancet Oncology has published a trial which involved 413 men across Europe.

The men (limited to those classified with low risk cancer) were assigned to receive either VTP or active surveillance and the data showed that of those who received VTP, 49% were in complete remission two years later. In addition, only 6% of patients who underwent the VTP needed to have their prostate removed, compared with 30% that did not undergo the new treatment. It is also reported that the impact on sexual activity and urination lasted no more than three months in patients who underwent VTP and there were no significant side effects after two years.

Whilst this new treatment is not yet currently available, the data from the trial is extremely encouraging and in due course may provide an alternative to patients who do not want the uncertainty of waiting to see if their cancer becomes worse. If the treatment does become widely available, the challenge will of course be identifying which patients are suitable for VTP so as not to over/under treat and to ensure that patients are provided with all relevant information about their treatment options to enable them to make a well informed choice as to which treatment option to pursue.